A Country Doctor Writes:

Today at the nursing home in the next town, where I occasionally admit patients, there was an elderly gentleman sitting in a chair right across from the nurses’ station. As he leaned forward in his chair, a red light turned on at the top of a small box on the back of his chair and a slightly metallic woman’s voice said sternly “Albert, please sit down” four times in a row. The old man just sat there, frozen, and a bewildered frown spread across his brow.

“I am sitting down”, he said in a meek and exasperated voice as one of the nurse’s aides came over. She explained to the old gentleman that he needed to lean back more in his chair as she silenced the alarm.

A curious sadness filled my heart as I returned to my charting at the nurses’ station. The mechanical voice had started inappropriately just because the poor fellow leaned forward in his chair, and at the time of day this took place, in the middle of the afternoon and right across from the nurses’ station, the whole electronic getup seemed unnecessary and a bit dehumanizing.

It reminded me of a video presentation I had witnessed about heart failure patients in their homes, sitting down in front of a computer screen with a blood pressure cuff and an oximeter. After entering their information and strapping on the blood pressure cuff, a computerized voice said “Good job!” and the elderly person would get on with their morning routine while a Registered Nurse somewhere would start her day at her computer screen and see the uploaded information from her various clients. She would then call the ones who had gained weight or showed abnormal vital signs. I remember feeling a bit disturbed about the computerized voice giving positive feedback to an elderly woman, who seemed a bit forlorn as she navigated the digital communication. I wondered how much longer it would have taken if she and the nurse had been on the telephone together at that time and chatted in person about how she was doing.

Health care without the personal touch is not what it used to be when people answered telephones and gave comfort and advise in person.

Today I also had to call the cardiology office at Cityside Hospital. The computerized voice said what she always says:

“Thank you for calling Cityside Cardiology. Please listen to the entire menu as our options have changed. If this is an emergency, please hang up and dial 911 or your local emergency number. If you are a physician or a physician extender and need to speak to a cardiologist now, please press ‘one’.” The other options were many and confusing and I was relieved I wasn’t elderly, sick or scared and trying to maneuver that system. The automated switchboards also don’t work for those of my patients who have rotary phones.

Our clinic doesn’t have the latest technology, and I am proud that we have human beings answering the telephones for our patients.

This evening, I had to call American Express to pay my monthly bill. A cheerful, youngish woman asked me to punch in my credit card number, then said “just a moment while I look up your account – okay, found it! – and for security purposes, I see that the number you are calling from matches…” Her comforting voice walked me through the transaction I have made so many times before, and even remembered my checking account number from last time. At the end, she said in a reassuring tone “You’re all set…”, gave me my confirmation and told me “you can go ahead and hang up”. She sounded nicer than many of the live voices I had talked to today. Actually, she was a pleasure to deal with.

Mechanical voices and computers can be okay if they make a transaction convenient, quick and logical, like using the automated check-in at the airport if you are an experienced traveler. But if you are unfamiliar with the system, elderly, sick or scared, you deserve a human voice with some heart and caring behind it.